輸尿管癌之放射線學診斷

The Radiological Evaluation of Ureteral Carcinoma

沈戊忠(Wu-Chung Shen) ； 于俊(Chun Yu)

《中華放射線醫學雜誌》 7卷1期 (1982/03) Pp. 27-43

摘要

本文根據六年半以來榮總之22例輸尿管癌病人，回顧與分析其放射線檢查之徴象。這22例病患之平均年齡為62歲，其臨床症狀以大量血尿(72.7%)為最多。腫瘤多發生於輸尿管之下1/3處(68%)。95%的患側腎臟具有腎水腫，而59%的腎水腫巳嚴重到無功能。輸尿管癌在輸尿管影像(ureterogram)可呈現多種不同的徵象，雖無特殊性，但可提供精確的阻塞位置。無功能的腎水腫在CT上可見－共同特徵，即腎臟體積不變大，腎實質變薄，腎盃腎盞擴張而以腎盃擴張為主，在血管攝影則可見到肥皂泡狀腎水腫圖樣。做過CT檢查的病例中，87.5%(7/8)可由CT精確的表現出腫瘤的位置及大小。

並列摘要

Primary ureteral carcinoma is rare, accounts for an estimate 1 percent of all carcinoma of the GU tract. In this report we collect 22 cases of primary ureteial carcinoma in VGH from 1976 to 1981, June, and review their clinical symptoms and radiological examinations performed in Radiological Department, including IVP, angiography, CT and antegrade pyelogram.
Average age of the patients is 62 years old. The most frequent symptom is hematuria (72.9%), and average duration of hematuria before presenting was 4.8 months. The lower 1/3 of ureter is the frequent location (68%).
95% of patients have hydronephrosis, in which 40% could be found by IVP, but another 59% were non-functioning and could not visualized in IVP, but these non-functioning hydronephrosis were 100% presented by CT and antegrade pyelogram, and 60% by angiography. Those nonfunctioning hydronephrosis have same characteristics: nonenlargement of the size, very thinning of the cortex, pyelocaliectasis with predominantly pyelectasis.
87.5% of tumors could be detected by CT, but only 1 case revealed tumor vessels in angiography.